Mehmet HACIYANLI, Serkan KARAISLI, Selda GÜCEK HACIYANLI, Burak KOYUNCU

TİROİD KANSERİNDE PROFİLAKTİK VE TERAPÖTİK SANTRAL LENF NODU DİSEKSİYONU SONUÇLARININ KARŞILAŞTIRILMASI

Giriş: Santral lenf nodu diseksiyonu (SLND) papiller tiroid kanseri tedavisinde terapötik veya profilaktik amaçla uygulanan ve yaşam kalitesini etkileyen birtakım komplikasyonlara neden olabilen bir cerrahi girişimdir. Bu çalışmada, kliniğimizde terapötik ve profilaktik SLND uygulanan hastaların klinikopatolojik özellikleri ile cerrahi komplikasyonlarını karşılaştırmayı amaçladık. Gereç ve Yöntem: Ocak 2016- Aralık 2020 tarihleri arasında, kliniğimizde papiller tiroid kanseri nedeniyle aynı seansta total tiroidektomi ve SLND uygulanan 43 hasta çalışmaya dahil edildi. Hastalar, terapötik SLND (Grup 1) ve profilaktik SLND (Grup 2) olarak iki gruba ayrıldı. Grupların demografik özellikleri, klinikopatolojik verileri ile cerrahi komplikasyonlar karşılaştırıldı. Bulgular: Grup 1’de 34, grup 2’de 9 hasta vardı. Hastaların yaş ortalaması grup 1 ve 2’de sırasıyla 44,7±14,1 ve 37,1±11,1 olarak bulundu. Her iki grupta da hastaların çoğu kadındı. Yaş, cinsiyet, papiller kanser alt tipi, tümörün yerleşimi ve histolojik özellikleri ile komplikasyon oranı her iki grupta da benzerdi (p>0,05). Grup 1’de diseke edilen lenf nodu ile metastatik lenf nodu sayısı yüksek bulundu (sırasıyla p=0,021 ve p=0,0002). Kalıcı komplikasyonlar kıyaslandığında gruplar arasında anlamlı fark izlenmedi (p=0,209). Sonuç: Terapötik ve profilaktik SLND, cerrahi komplikasyon riski yüksek olan girişimlerdir. SLND’nun terapötik olarak uygulanmasının daha uygun olduğu kanaatindeyiz.

COMPARISON OF PROPHYLACTIC AND THERAPEUTIC CENTRAL LYMPH NODE DISSECTION RESULTS IN THYROID CANCER

Introduction: Central lymph node dissection (CLND) is a surgical procedure performed for therapeutic or prophylactic purposes in patients having thyroid papillary cancer and may cause some complications that affect quality of life. In this study, we aimed to compare the clinicopathological features and surgical complications of the patients who underwent therapeutic and prophylactic CLND in our clinic. Material and Methods: Forty-three patients who underwent total thyroidectomy and CLND in the same session for papillary thyroid cancer between January 2016 and December 2020 in our clinic were included in the study. The patients were divided into two groups as therapeutic CLND (Group 1) and prophylactic CLND (Group 2). Demographic characteristics, clinicopathological data of the groups and surgical complications were compared. Results: There were 34 patients in group 1 and 9 patients in group 2. The mean age of the patients in group 1 and group 2 was 44.7±14.1 and 37.1±11.1, respectively. Most of the patients in both groups were women. Age, gender, papillary carcinoma subtype, tumor location and histological features, and complication rate were comparable in both groups (p>0.05). The number of dissected lymph nodes and metastatic lymph nodes were significantly higher in group 1 (p=0.021 and p=0.0002, respectively). When permanent complications were compared, no significant difference was observed between groups (p=0.209). Conclusion: Therapeutic and prophylactic CLND are interventions with a high risk of surgical complications. We believe that the therapeutic application of CLND is more appropriate.

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